Aboriginal and Torres Strait Islander Health: planning the next decade

“Aboriginal health’ means not just the physical wellbeing of an individual but refers to the social, emotional and cultural wellbeing of the whole Community in which each individual is able to achieve their full potential as a human being, thereby bringing about the total wellbeing of their Community. It is a whole-of-life view and includes the cyclical concept Aboriginal and Torres Strait Islander Health: planning the next decadeof life-death-life”.

- National Aboriginal Health Strategy (1989)

Released in late July 2013, the Australian Government’s national plan to improve Indigenous people’s health was hailed as “a pathway for Aboriginal and Torres Strait Islander health policy for the next 10 years” – by the Government.

Predictably, the Coalition was less enthusiastic, branding it “business as usual”, and accusing Labor of politicising an issue that is “usually bi-partisan” – not that anyone has noticed.

The plan, a handsome document indeed, was launched by the Minister for Indigenous Health Warren Snowdon who described it as “central to the Australian Government’s targeted approach to ensure that Aboriginal and Torres Strait Islander people can enjoy the same standard of health as other Australians…it continues the significant efforts made by the Australian Government since the establishment of the Closing the Gap Framework in 2008.”

The plan followed a series of 17 nationwide consultations with Aboriginal and Torres Strait Islander individuals, communities and groups, and representatives from departments with complementary health and social determinants.

To these were added over 140 written submissions and a series of roundtables to gather expertise on a range of specific issues relevant to Aboriginal and Torres Strait Islander health, and input from the Australian Government’s National Aboriginal and Torres Strait Islander Health Equality Council and the Health Plan Stakeholder Advisory Group.

Over the next 10 years, projected funding for health programs specifically designed and targeted to Aboriginal and Torres Strait Islander people is estimated to be around $12 billion from 2013-14 to 2023-24.

This funding is in addition to health services provided and funded for the whole population through hospitals, Medicare and the PBS, and other Commonwealth investments to improve the social determinants of health, including education, employment and housing.

The report was conducted by the University Centre for Rural Health, Bullinah Aboriginal Health Service, Casino Aboriginal Medical Services, and Northern NSW Local Health District under the guidance of Dr Michael Douglas. The snapshot of health and disease indicators – by no means ‘cherry-picked’ for the bad news – included:

While 68% men and 53% women achieve adequate levels of physical activity, obesity rates are twice those of the non-Aboriginal community.

There has been some fluctuation on mortality rates, but Aboriginal deaths have remained at least 1.5 – 2 times that of non-Aboriginal.

10% of all Aboriginal babies weigh less than 2,500 gm., almost twice that of the non-Aboriginal community.

Despite a steady decline in infant deaths in the Aboriginal community over the past decade, the Aboriginal infant mortality is still 1.5 times that of non-Aboriginal infant.

By 24 months of age, 92.4% of local Aboriginal children are fully immunized, but by 5 years, this falls to 76.4%

Aboriginal youth are 3 times as likely to live in over-crowded housing as non-Aboriginal youth, a third of Aboriginal youth have high or very high levels of psychological stress, and are 2 – 3 times more likely than non-Aboriginal youth to be daily smokers.

Overall rates of incarceration for adults and youth are about 25 times that of non-Aboriginals.

Hospitalisation rate (3802/100,000) is 40% higher for Aboriginal people compared to non-Aboriginal persons – and the gap is increasing..

The prevalence of end-stage kidney disease in male and female Indigenous populations is 5 times higher in males (438/100,000) and 9 times higher in females (439/100,000) than non-Aboriginal populations.

The rate of new Hepatitis C infection is 140/100,000 in the Aboriginal community. This continues to rise and is three times higher than the non-Aboriginal population.

About half of all Aboriginal adults smoke, about 2.6 times more likely than non-Aboriginal persons; hospitalisation in Northern NSW hospitals for condition resulting from smoking are similarly 2 – 3 times more frequent. Smoking contributes to 17% in the gap in life expectancy between Aboriginal and non-Aboriginal populations.